What is the most effective way to avoid carpal tunnel syndrom or tendonitis?

My wife and I both do an excessive amount of typing. I with school and book, she with book. Our offices are set up quite nicely. Faces the required distance from the screen, legs comfy under the desk. Big windows to look out when we’ve been looking at the screen too long. However, the other day my left and right index finger started to hurt near the knuckle closest to the palm. I deduced that there was something I was doing wrong with my work area at home. I have a straight keyboard and normal mouse. (normal being track-ball, and two clicks)

So is there a verifyable way to avoid tendonitis or carpal tunnel that I am over looking? Could it be my keyboard and/or mouse?

Whats the Dope?

The advice I got from my doctor when I got it was to take regular breaks - say 5 mins in every 60, and to rest/exercise your arms regularly. For example, instead of leaving your hand resting on the mouse when you’re not actually mousing/typing, drop it by your side, shake it a few times, flex the hand from the wrist, wiggle the figers etc. Do the same for the other hand when you remember/you’re not using it to type with. I was told that the RSI (Repetitive Stress Injury - the usual term for tendonitis/carpel tunnel syndrome in the UK) suffers from two factors - the damage caused by the repetitive motion & also the poor circulation caused from the odd, mostly still position of the arms. The poor circulation hinders mending, so resting helps alleviate the damage causing & the gentle (non-repetitive) exercise stimulates the circulation.

I don’t guarantee that it will prevent it, but that’s the medical advice I was given when I developed it & seemed to help - I was also given a sheet with specific exercises on that I was to do three times a day, but that would differ depending on RSI damage location. If in doubt, see your own doctor & ask them about exercises you can do to stretch the tendons gently & keep the circulation going in your arms when doing long batches of computing.

There are some cheap things you can do to prevent the onset of CTS.

  • Take a five-minute break every hour. Stand up, walk around and shake your hands vigorously to reinvigorate blood flow.

  • Get one of those gel-filled pillows that go across the bottom of the keyboard. Also, get a mousepad with a gel-pad at the bottom. Multiple manufacturers make these things, such as Kensington and Fellowes. Any computer supply store should have them.

  • You may want to get a pair of cheap fingerless weightlifting gloves from a supermarket or sports shop. Get a pair that has padding across the lower palm and wrist. These will keep your hands in a straight, natural position that prevents cramping. If it works for weightlifters, it will certainly work for you.

Wrong. Do not rest your hand or wrist on anything while typing. Those pads are for resting your hands on while NOT typing.

Keep your hand, wrist, and forearm in a straight line while typing. In other words, your wrist shouldn’t be bent up/down or left/right. I think the left/right is more important, though. This is what the ‘natural’ keyboards are meant to improve. The angle of the two sets of keys should make it easy to keep your wrist straight in the left/right dimension. The braces you see carpal tunnel sufferers wearing forces the wrist to stay straight.

tendonitis is the inflamation of the tendon. There are drugs out there that block the chemical in the body that causes inflamation…mobic, vioxx, and celebrex come to mind. these are often prescibed for athletes with/and to prevent tendonitis and old people with arthritis…see if you doctor will give a prescription.
Drugs such as aspirin, iburprofen (motrin), and naproxen sodium (aleve) reduce inflamation after it has started…hence take one of these after you get tendonitis if you don’t get a presecription for something that will prevent it.

Be cautious with anti-inflammatories such as those mentioned above. To get the inflammation-fighting effect, they must be taken regularly in prescription-strength doses for a few weeks at least. Otherwise they just reduce pain and fever and may promote bleeding. They can be hard on one’s kidneys and one’s stomach lining. They are not a cure-all, and discussion with one’s physician should be undertaken before going on them chronically.

QtM, MD

I can’t speak for the UK usage, but in America, RSIs are a class of problems, and CTS and tendonitis are both types of RSIs.

IMHO, I think you’ve got enough to go on with the exercises listed above, however, there is also a specific reason to keep your arms straight. My wife is now recovering from Cubital Tunnel Syndrome, this is swelling of the ulnar nerve (funny bone). This is caused by holding the arms at a 90° position and not allieviating the stress and weight from the elbow. Constant tingling from the funny bone region leads to numbness of the ring finger and pinky until loss of feeling.
They had to release the nerve from its protective sheath and remove some bone to relieve pressure. She is at month 4 of the recovery process, out of 15 according to the Doc.
Good luck to the book writing!

Something to take the weight of your arms is extremely important, especially for the mouse arm.

My own little brush with tendonitis: Some time ago I bought a new computer desk, of the type that has a little drawer under the desk top that slides out and holds the keyboard and mouse. I ended up sitting with my elbows bent roughly 90° and outwards, and whenever I used the mouse, I rested my arm on the lower part of my palm. Pretty soon I was experiencing chronic, disabling arm pain, and it was just getting worse.

I bought a different desk and the pain disappeared after a couple of weeks. This desk has a curved dent which gives me ample space to rest both elbows, and to move the mouse around without having to bend my elbow or wrist into awkward angles.

Keep your hands in line with your arms (so the tendons run in a straight line, not around corners). That means wrists straight.

Keep your elbows at 90[sup]o[/sup] and by your side. Also keep knees and hips at 90[sup]o[/sup].

Keep your hands relaxed. Dont ‘fight’ the mouse or ‘pound’ the keyboard.

Take regular and frequent breaks with stretching exercises, as suggested earlier. Some research suggests that these syndromes are also related to ‘knots’ of neurons in the brain, reflecting repetatively learnt movements. Using your body differently can undo these to an extent. I know this sounds strange - I would ask for a cite - I cant find one - read it in New Scientist a while ago.

While your at it, adjust the height of the monitor so that the top of the screen is level with your eyes. Also adjust your chair so that your spine is close to verticle and your lumber area supported. This prevents slouching, which leads to shoulder, neck and back strain.

So basically reduce all the forces in your body, so that there is less strain on muscles and connective tissue.

oh … and keep the mouse close to your body and keyboard, so you dont have to reach out to it. Get a compact keyboard, if you are right handed.

This site has some exercises that I’ve found helpful.